Lastet

Lastet is an antitumor drug with a plant base.

Indications Lasteta

It is used to treat germ cell tumors in the ovaries or testicles, and also for lung cancer.

There is also information on the effectiveness of using the drug in the treatment of Hodgkin's disease, bladder cancer, NHL, acute leukemia (myeloblastic and monoblastic types), trophoblastic tumors, gastric cancer, as well as neuroblastoma and Kaposi's angiosarcoma.

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Release form

The drug is released in capsules of 25, 50 or 100 mg, 10 pieces per blister. The pack contains 1 blister plate with capsules of 100 mg; 2 blister plates with capsules of 50 mg; 4 blister plates with capsules of 25 mg.

Pharmacodynamics

Etoposide is a semi-synthetic derivative of the substance podophyllotoxin. It acts by inhibiting topoisomerase II. The substance has cytotoxic properties, damaging DNA. The drug interferes with mitosis, leading to cell death during the G2 stage, as well as during the late S-stage of the mitotic cycle. High levels of the substance provoke cell lysis during the pre-mitotic stage.

In addition, etoposide interferes with the passage of nucleotides through the plasma membrane, preventing DNA from being synthesized and repaired.

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Pharmacokinetics

After oral administration, the active substance is absorbed from the gastrointestinal tract. The average bioavailability is 50% and remains so regardless of food intake.

The drug is observed in saliva, pleural fluid, kidneys and spleen, and also in myometrium and liver and brain tissue. It passes through the placenta and BBB. The values of the substance in the cerebrospinal fluid fluctuate from unknown values to 5% of the concentration level in blood plasma. There is no information on the drug getting into breast milk. Protein synthesis in plasma is approximately 90%.

The drug undergoes an active metabolism process, and its excretion occurs in 2 stages. The average half-life in adults who do not have problems with the liver and kidneys is approximately 0.6-2 hours. At the final stage, this figure is within 5.3-10.8 hours. In a child with healthy liver and kidney function, the average half-life of the substance at the initial stage is 0.6-1.4 hours, and at the final stage - about 3-5.8 hours.

Etoposide is excreted unchanged (29% of the substance) and in the form of metabolites (approximately 15%) in the urine over 48-72 hours. About 2-16% of the drug is excreted in the feces.

Dosing and administration

The dose sizes are prescribed individually, taking into account the chemotherapeutic regimen used. In case of oral administration, the drug is taken every day at 50 mg/ ^m2 for 14-21 days. Then the cycle is repeated at intervals of 28 days or taken for 5 days at 100-200 mg/m2 ^, making 3-week intervals between courses.

The course can be repeated only after stabilization of peripheral blood values. When selecting dosages, it is necessary to take into account the myelosuppressive properties of other drugs in combination, as well as the effect of previously performed chemotherapy and radiation therapy.

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Use Lasteta during pregnancy

It is prohibited to use Lastet during pregnancy.

Contraindications

Main contraindications:

• intolerance to etoposide or additional components of the drug;
• severe stage of myelosuppression;
• severe problems with kidney or liver function;
• acute forms of infectious processes;
• lactation period.

There is no data on the effectiveness or safety of using the drug in children.

Side effects Lasteta

Using the medicine may cause the following side effects:

• damage to the hematopoietic system: a decrease in the number of granulocytes with leukocytes (this value depends on the size of the dose taken and is considered the most basic toxic symptom of the drug, due to which it is necessary to limit the dosage). The peak decrease in the number of granulocytes is mainly noted in the period of 7-14 days after taking the drug. Thrombocytopenia develops less often, and the peak decrease in the platelet level is noted in the period of 9-16 days. Blood values are often restored by the 20th day after taking a standard dose. Anemia is sometimes noted;
• Gastrointestinal reactions: approximately 30-40% of patients experience vomiting and nausea. Often, such symptoms are moderate in severity, and the drug rarely has to be discontinued because of them. To control such complications, antiemetic drugs should be used. Abdominal pain, anorexia with esophagitis, stomatitis and dysphagia, as well as diarrhea were also observed. Sometimes, transient mild hyperbilirubinemia and increased transaminase levels are noted. Often, such a disorder develops in the case of taking excessively high doses;
• Disorders of the cardiovascular system: as a result of rapid intravenous injection of the drug, 1-2% of patients experienced a transient decrease in blood pressure, which was often restored after stopping the injection and administering fluid or other supportive treatment. If drug administration needs to be resumed, it is recommended to reduce the injection rate;
• manifestations of allergy: signs that are similar to anaphylactic symptoms - for example, tachycardia, chills, dyspnea, fever and bronchospasm;
• dermatological lesions: curable alopecia (may sometimes cause complete hair loss - in about 66% of those treated). Occasionally, itching or pigmentation develops. A relapse of the radiation form of dermatitis was noted once;
• Other symptoms: occasionally a feeling of severe fatigue or drowsiness is noted, as well as polyneuropathy, residual taste in the mouth, muscle cramps, fever, temporary blindness of cortical origin, hyperuricemia or metabolic acidosis.

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Interactions with other drugs

The antitumor properties of the drug are potentiated in the case of its combination with the substance cisplatin, but in this case it is necessary to take into account that people who have previously used cisplatin may have problems with the excretion of etoposide.

As a result of the combination of Lastet and cyclosporine, the half-life of etoposide is extended by 2 times.

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Storage conditions

Lastet should be kept in a place inaccessible to children, and at a room temperature of 5-25°C.

Special instructions

Reviews

Lastet is a fairly effective remedy, but reviews of it also show that its use often causes the development of negative reactions - an increase in bilirubin levels, and in addition, a change in the values of red blood cells, as well as hemoglobin.

The response to chemotherapy varies from patient to patient, with some experiencing no complications during the initial courses, while others may experience nausea, vomiting, and loss of appetite.

Shelf life

Lastet in capsules of 50 and 100 mg can be used for a period of 3 years, and in capsules of 25 mg - 2.5 years from the date of release of the drug.